Русский
Possibilities of local injection therapy for work-associated knee osteoarthritis
DOI: https://dx.doi.org/10.18565/therapy.2025.1.64-73
Shokhin A.A., Trofimova A.S., Trofimov E.A.
1) Severodvinsk City Hospital No. 1; 2) I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg
The aim: to estimate and compare the efficacy of intra-articular injections of hyaluronic acid (HA) and platelet-enriched plasma (PEP) in patients with knee OA associated with work activity.
Material and methods. In the frames of a randomized controlled study, data from 65 patients (35 females and 30 males) aged 30–55 years with knee OA stages I–II according to Kellgren – Lawrence, who had high work physical activity were analyzed. All the participants were divided into three groups: group 1 (n = 25) received diacerein, group 2 (n = 22) – diacerein and LIT HA, group 3 (n = 18) – diacerein and PEP. The criteria for efficacy were changes in pain syndrome (Visual Analogue Scale, VAS), functional test indexes (WOMAC, Lequesne index), need for non-steroidal anti-inflammatory drugs (NSAIDs), and ultrasound examination data. The observation was carried out for 24 weeks with regular visits and symptoms monitoring.
Results. The most significant clinical effect was achieved in patients from HA group: pain during work activities regressed by 47%, at rest – by 56%. The group using PEP also demonstrated a significant reduction in pain syndrome in both cases – by 36 and 45%, respectively. Among patients using diacerein monotherapy, similar indexes (25 and 35%) were statistically lower than in LIT groups. Concerning the improvement of functional scale values and reduction in need for NSAIDs, the group of patients receiving HA injections was also leading, ahead of the PEP therapy group. According to the data of ultrasound examination, no significant changes in cartilage thickness were observed in the compared groups during the study period. Reactive synovitis developed in some patients in PEP group.
Conclusion. Combined use of diacerein and HA is a preferred method of treating work-related knee OA not only because of its higher efficacy demonstrated in our study, but also because of the absolute sterility and standardized manufacturing technique of the HA drug injected into the joint cavity.
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About the Autors
Andrey A. Shokhin, MD, rheumatologist at Severodvinsk City Hospital No. 1. Address: 164504, Severodvinsk, 47 Lomonosova St.
E-mail: andra.11@yandex.ru
ORCID: https://orcid.org/0009-0000-5440-237X. eLibrary SPIN: 8922-1101
Anna S. Trofimova, MD, PhD (Medicine), assistant at the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: Anna.Trofimova@szgmu.ru
ORCID: https://orcid.org/0000-0001-5926-7912. eLibrary SPIN: 6827-3934
Evgeny A. Trofimov, MD, Dr. Sci. (Medicine), professor, professor of the Department of therapy, rheumatology, examination of temporary disability and quality of medical care with a course in hematology and transfusiology named after E.E. Eichwald, I.I. Mechnikov North-West State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya St.
E-mail: Evgeniy.trofimov@szgmu.ru
ORCID: https://orcid.org/0000-0003-3236-4485. eLibrary SPIN: 4358-1663
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